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Prevalence of non-alcoholic fatty liver disease in patients with nephrotic syndrome:A population-based study

World Journal of Hepatology 2023年第2期15卷 265-273页

作者： Somtochukwu Stephen Onwuzo Asif Ali Hitawala Antoine Boustany Prabhat Kumar Ashraf Almomani Chidera Onwuzo jessy mascarenhas monteiro Imad Asaad Internal Medicine Cleveland Clinic FoundationClevelandOH 44111United States Digestive Disease and Hepatology Cleveland Clinic Foundation FloridaWestonFI 33331United States Department of Medicine&Surgery General Hospital Lagos IslandLagos Island 101223LagosNigeria Department of Medicine Ross University School of MedicineBridgetown B11093St MichaelBarbados Digestive Disease and Hepatology Cleveland Clinic FoundationClevelandOH 44111United States

BACKGROUND Non-alcoholic fatty liver disease(NAFLD) is a global health concern with a prevalence of about 25% amongst United States adults. Its increased prevalence is attributed to increase in patients with obesity and metabolic syndrome, partly due to similar mechanisms of injury. Nephrotic syndrome(NS) is a clinical entity resulting from extensive proteinuria leading to hypoalbuminemia, hyperlipidemia, edema, and other complications. Given its association with hyperlipidemia, there is concern that patients with NS may be at increased risk of *** To perform a cross-sectional population-based study to investigate the prevalence and risk factors of NAFLD in patients with *** A large multicenter database(Explorys Inc., Cleveland, OH, United States) was utilized for this retrospective cohort study. A cohort of 49700 patients with a diagnosis of “Non-Alcoholic fatty liver disease” using the Systematized Nomenclature of Medicine-Clinical Terms(SNOMED-CT) between 1999-2022 was identified. Inclusion criteria were age ≥ 18 years, presence of NAFLD, presence of NS. There were no specific exclusion criteria. Univariate and multivariate analysis were performed to adjust for multiple risk factors including age, gender, Caucasian race, NS, type Ⅱ diabetes mellitus, hypothyroidism, dyslipidemia, obesity, metabolic syndrome and chronic kidney disease. Statistical analysis was conducted using R, and for all analyses, a 2-sided P value of < 0.05 was considered statistically *** Among the 78734750 individuals screened in this database, there were a total of 49700 subjects with NAFLD. In univariate analysis, the odds of having NAFLD in patients with NS, type 2 diabetes mellitus, hypothyroidism, dyslipidemia, obesity, metabolic syndrome and chronic kidney disease were 14.84 [95% confidence interval(95%CI) 13.67-16.10], 17.05(95%CI 16.78-17.32), 6.99(95%CI 6.87-7.11), 13.61(95%CI 13.38-13.84), 19.19(95%CI 18.89-19.50), 29.09(95%CI 28.26--29.95), and 9.05(95

关键词： Non-alcoholic fatty liver disease Nephrotic syndrome Chronic kidney disease Hyperlipidemia Population-based study Database

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Essential role of small bowel capsule endoscopy in reclassification of colonic inflammatory bowel disease type unclassified

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World Journal of Gastrointestinal Endoscopy 2017年第1期9卷 34-40页

作者： Sara monteiro Francisca Dias de Castro Pedro Boal Carvalho Bruno Rosa Maria Joao Moreira Rolando Pinho Miguel mascarenhas Saraiva José Cotter Department of Gastroenterology Hospital da Senhora da Oliveira-Guimaraes ManopH-Endo-scopy and Digestive Motility Laboratory Portugal and CUF Institute School of Medicine University of Minho ICVS/3B’s PT Government Associate Laboratory

AIM To evaluate the role of small bowel capsule endoscopy(SBCE) on the reclassification of colonic inflammatory bowel disease type unclassified(IBDU).METHODS We performed a multicenter, retrospective study including patients with IBDU undergoing SBCE, between 2002 and 2014. SBCE studies were reviewed and the inflammatory activity was evaluated by determining the Lewis score(LS). Inflammatory activity was considered significant and consistent with Crohn's disease(CD) when the LS ≥ 135. The definitive diagnosis during follow-up(minimum 12 mo following SBCE) was based on the combination of clinical, analytical, imaging, endoscopic and histological *** Thirty-six patients were included, 21 females(58%) with mean age at diagnosis of 33 ± 13(15-64) years. The mean follow-up time after the SBCE was 52 ± 41(12-156) mo. The SBCE revealed findings consistent with significant inflammatory activity in the small bowel(LS ≥ 135) in 9 patients(25%); in all of them the diagnosis of CD was confirmed during follow-up. In 27 patients(75%), the SBCE revealed no significant inflammatory activity(LS < 135); among these patients, the diagnosis of Ulcerative Colitis(UC) was established in 16 cases(59.3%), CD in 1 case(3.7%) and 10 patients(37%) maintained a diagnosis of IBDU during follow-up. A LS ≥ 135 at SBCE had a sensitivity = 90%, specificity = 100%, positive predictive value = 100% and negative predictive value = 94% for the diagnosis of *** SBCE proved to be fundamental in the reclassification of patients with IBDU. Absence of significant inflammatory activity in the small intestine allowed exclusion of CD in 94% of cases.

关键词： Inflammatory bowel disease Inflammatory bowel disease type unclassified Capsule endoscopy Crohn’s disease Lewis score Reclassification

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